Citation Nr: 0813261 Decision Date: 04/22/08 Archive Date: 05/01/08 DOCKET NO. 02-12 771A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Columbia, South Carolina THE ISSUE Entitlement to service connection for a body rash. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Patricia A. Talpins, Associate Counsel INTRODUCTION This matter comes before the Board of Veterans' Appeals ("BVA" or "Board") on appeal from a July 2001 rating decision of the Department of Veterans Affairs ("VA") Regional Office ("RO") in Columbia, South Carolina in which the RO denied the benefit sought on appeal. The appellant, who had active service from July 1970 to January 1972, appealed that decision to the BVA. Thereafter, the RO referred the case to the Board for appellate review. The appellant testified at a personal hearing before the undersigned Veterans Law Judge in December 2003. The Board remanded the case for further development in June 2004 and then again in January 2007. The requested development has been completed; and the case has been returned to the Board for further review. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the appellant's appeal has been obtained. 2. A skin disorder, to include a body rash, did not manifest in service and is not shown to be causally or etiologically related to service. CONCLUSION OF LAW A skin disorder, to include a body rash, was not incurred in or aggravated during service. 38 U.S.C.A. §§ 1110, 1110, 5103, 5103A, 5107 (West 2002 & Supp. 2006); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.306 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSION A. The Veterans Claims Assistance Act With respect to the appellant's claim of entitlement to service connection for a body rash, VA has met all statutory and regulatory notice and duty to assist provisions. See 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126 (West 2002 & Supp. 2006); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326 (2007). Prior to the initial adjudication of the appellant's claim, a letter dated in March 2001 fully satisfied the duty to notify provisions. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b)(1); Quartuccio v. Principi, 16 Vet. App. 183 (2002). The appellant was aware that it was ultimately his responsibility to give VA any evidence pertaining to his claim. The March 2001 letter informed the appellant that additional information or evidence was needed to support his service connection claim; and asked the appellant to send the information to VA. Pelegrini v. Principi, 18 Vet. App. 112 (2004)[Pelegrini II]. In addition, the appellant was provided additional VCAA letters after the Board's June 2004 and January 2007 remands that also informed him of what was necessary to substantiate his claim. See June 2004 and January 2007 Board decisions; June 2004, December 2004 and March 2007 VCAA letters sent by the Appeals Management Center. Subsequent to receipt of these additional notices, the RO readjudicated the appellant's claim and provided the appellant with Supplemental Statements of the Case ("SSOC") in June 2006 and December 2007. Mayfield v. Nicholson, 499 F.3d 1317 (Fed. Cir. 2007) [Mayfield III]. The appellant's service medical records, VA treatment records and identified private medical records have been obtained, to the extent possible. 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159. There is no indication in the record that any additional evidence, relevant to the issue decided herein, is available and not part of the claims file. In this regard, the Board observes that the appellant was afforded a VA examination in February 2000 in connection with his service connection claim; and that the Board remanded the appellant's claim in January 2007 for another VA dermatology examination for the purpose of obtaining a medical opinion addressing the nature and etiology of his appellant's alleged skin disorder. See January 2007 BVA decision, pgs. 11-12. However, the appellant failed to report for his scheduled July 2007 examination. July 2007 notice to file. Due to this failure to appear, the Board must decide the appellant's claim based upon the current evidence of record. See 38 C.F.R. § 3.655 (When a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record). Lastly, the Board observes that prior to recertification of the appellant's appeal, the RO provided the appellant with an explanation of disability ratings and effective dates. March 2007 letter from the Appeals Management Center; Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). Regardless, since the Board concludes below that the preponderance of the evidence is against the appellant's claim of entitlement to service connection for a body rash, any questions as to the appropriate disability rating or effective date to be assigned to that claim are rendered moot, and no further notice is needed. Id. B. Law and Analysis The appellant contends that he is entitled to service connection for a body rash on the basis that (1) he developed rashes on his body and hands while in service, and (2) that he developed rashes on his chest area, face, hands, groin and legs after his separation from service. See November 1999 application for compensation; statement with September 2002 VA Form 9; June 2003 RO hearing transcript, p. 3. While viewing the evidence in the light most favorable to the appellant in this case, the Board finds that the preponderance of the evidence is against the appellant's claim. Therefore, the appeal must be denied. Applicable law provides that service connection will be granted if it is shown that a veteran has a disability resulting from an injury suffered or disease contracted in the line of duty, or for aggravation of a pre-existing injury suffered or disease contracted in the line of duty, in the active military, naval or air service. 38 U.S.C.A. § 1110 (West 2002); 38 C.F.R. § 3.303(a)(2007). In addition, service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. §§ 3.303, 3.304. Generally, to prove service connection, the record must contain: (1) medical evidence of a current disability, (2) medical evidence, or in certain circumstances, lay testimony, of an in-service incurrence or aggravation of an injury or disease, and (3) medical evidence of a nexus or relationship between the current disability and the in- service disease or injury. Pond v. West, 12 Vet. App. 341 (1999); Caluza v. Brown, 7 Vet. App. 498 (1995). With regard to the first element necessary for a grant of service connection (medical evidence of a current disability), the appellant's post-service medical records indicate that he has been diagnosed with an impetiginous rash on his legs and a pruritic rash of his crura region. See private medical records dated in June 2005. The claims file additionally contains other post-service medical records that indicate the appellant has at times experienced rashes involving other parts of the body. See private medical records dated in November 2000 and December 2000. The Board finds that these diagnoses constitute a current skin disability for VA purposes and fulfill the requirements of the first element for service connection. With regard to the second element of the service connection test, the evidence of record shows that the appellant was placed on a profile in service for developing a rash in the beard area of his face in November 1970. These same records indicate that the appellant was noted to have a rash on his chest in November 1971; and that he continued to be placed on profile for a shaving rash from November 1971 until his separation from service. See November 1971 service clinical record consultation sheet; November 1971 physical profile record. The appellant's remaining service medical records are silent in terms of treatment or diagnoses related to a skin disorder. However, while the appellant's service medical file does not contain his service separation examination report, it does contain a medical history report dated around the time of the appellant's discharge from service. July 1972 report of medical history. In that report, the appellant answered "yes" in response to the question of whether he ever had a "skin disease"; and stated that he had "a minor skin disease that come[s] and go[es] in the summer." Id. In light of the medical evidence indicating that the appellant developed skin rashes during his period of service, the Board finds that the requirements of the second element of the service connection test has been met. Thus, the sole question remaining for the Board to answer is whether the last element of the requirements to establish service connection, medical evidence of a nexus between the current disability and the in-service disease or injury, has been fulfilled. As referenced above, post-service medical records contained in the claims file reveal that the appellant has been diagnosed with rashes of the body several times since his discharge from service. Although the appellant's representative relies upon this evidence in arguing that service connection is warranted on the basis of a continuity of symptomatology (August 2006 appellate brief presentation, p. 2), the Board disagrees. The earliest post-service medical evidence documenting the appellant's rashes since service are dated in November 2000, over twenty-five years after he separated from service. See private medical records dated in November 2000, December 2000 and June 2005. While the appellant was afforded a VA examination in February 2000 in relationship to his skin disorder claim, no skin rash was found at that time. See VA examination reports dated in February 2000; July 2001 rating decision. The Board observes that the appellant was offered the opportunity to appear for another VA dermatology examination in July 2007 that would have (1) addressed the etiology of the appellant's post- service skin rashes and (2) provided a medical opinion as to whether these rashes were more likely than not related to the appellant's skin symptomatology in service; however, he failed to appear. January 2007 BVA decision; July 2007 note to file. Thus, the current post-service medical evidence contained in the claims file does not support the appellant's claim in that it neither reveals a continuity of symptomatology (i.e., evidence that the appellant developed skin rashes from the time he separated service until the present date) nor provides a medical nexus/link between a currently diagnosed skin rash and the skin symptomatology noted in service. As such, the Board finds that the third element necessary for service connection has not been met in this case. Absent fulfillment of this third element, service connection cannot be granted. Therefore, the Board finds that the preponderance of the evidence is against the appellant's claim of entitlement to service connection for a body rash. In reaching this decision, the Board has considered the doctrine of reasonable doubt. However, as a preponderance of the evidence is against the appellant's claim, the doctrine is not applicable. See Gilbert v. Derwinski, 1 Vet. App. 49 (1991). ORDER Service connection for a body rash is denied. ____________________________________________ S. L. Kennedy Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs